{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T11:23:30Z","timestamp":1787397810317,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    A systematic review of the ictal semiology of fronto\u2010opercular seizures in focal epilepsy was carried out to assess possible anatomical\u2010clinical correlations and help guide interpretation of ictal semiology during pre\u2010surgical evaluation. PubMed and Embase databases were searched using the following keywords: \u201cfronto\u2010opercular OR frontal opercular OR Frontal operculum OR superior perisylvian OR anterior opercular AND (epilep* or seizure).\u201d The date last searched was November 30th, 2025. Studies were selected if they concerned case series, including at least one fully documented patient and informative case reports with the following criteria: patients who underwent a resection limited to the fronto\u2010opercular cortex, and\/or patients for whom the epileptogenic zone (EZ) was proven by intracranial electroencephalogram (iEEG) with insular cortex exploration, and\/or by complementary noninvasive explorations. A total of 21 patients with fronto\u2010opercular epilepsy from 16 studies were included in the review. iEEG was performed in 15 (71%) patients and resection in 16 (76%) patients. The confidence level in the EZ was very high (Engel IA) for 5 patients, high (Engel I not specified IA or Engel IB) for 12 patients, and moderate for 4 patients. The presence of an aura was found in 67% (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200914\/21) of the patients with mainly non\u2010painful somatosensory sensations. This was more frequent in patients with an EZ in the precentral Rolandic operculum compared to those with an EZ in the prefrontal operculum (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20096 versus\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091, respectively,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.016). Ictal signs comprised elementary motor symptoms, speech dysfunction, complex motor behavior, respiratory symptoms, salivation, and laughter, with preserved consciousness. Pure fronto\u2010opercular epilepsy is rare, consisting mainly of contralateral elementary sensory aura especially for the Rolandic operculum. Common ictal signs are motor orofacial and brachial symptoms with preserved consciousness. Further studies including patients who underwent a successful resection limited to the frontal operculum are needed to confirm these anatomical\u2010clinical correlations.\n                  <\/jats:p>","DOI":"10.1002\/epd2.70257","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T13:58:35Z","timestamp":1777298315000},"page":"1047-1057","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ictal semiology in fronto\u2010opercular epilepsy: A systematic review"],"prefix":"10.1002","volume":"28","author":[{"given":"Zeynep","family":"Gokce\u2010Samar","sequence":"first","affiliation":[{"name":"Department of Pediatric Clinical Epileptology, Sleep Disorders, and Functional Neurology Hospices Civils de Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Montavont","sequence":"additional","affiliation":[{"name":"Department of Pediatric Clinical Epileptology, Sleep Disorders, and Functional Neurology Hospices Civils de Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Comajuan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Clinical Epileptology, Sleep Disorders, and Functional Neurology Hospices Civils de Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2593-8463","authenticated-orcid":false,"given":"Julitta","family":"de Bellescize","sequence":"additional","affiliation":[{"name":"Department of Pediatric Clinical Epileptology, Sleep Disorders, and Functional Neurology Hospices Civils de Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Panagiotakaki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Clinical Epileptology, Sleep Disorders, and Functional Neurology Hospices Civils de Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2076-5006","authenticated-orcid":false,"given":"Marietta","family":"Papadopoulou","sequence":"additional","affiliation":[{"name":"Department of Pediatric Clinical Epileptology, Sleep Disorders, and Functional Neurology Hospices Civils de Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthildi\u2010Athina","family":"Papathanasiou\u2010Terzi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Clinical Epileptology, Sleep Disorders, and Functional Neurology Hospices Civils de Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Toulouse","sequence":"additional","affiliation":[{"name":"Department of Pediatric Clinical Epileptology, Sleep Disorders, and Functional Neurology Hospices Civils de Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7233-2771","authenticated-orcid":false,"given":"Alexis","family":"Arzimanoglou","sequence":"additional","affiliation":[{"name":"Pediatric Epilepsy Unit, Department of Neurology Hospital Sant Joan de D\u00e9u  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karine","family":"Ostrowsky\u2010Coste","sequence":"additional","affiliation":[{"name":"Department of Pediatric Clinical Epileptology, Sleep Disorders, and Functional Neurology Hospices Civils de Lyon  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/NRL.0b013e31821733db"},{"key":"e_1_2_11_3_1","first-page":"3","article-title":"Clinical semiology of frontal lobe seizures","volume":"57","author":"Bancaud J","year":"1992","journal-title":"Adv 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